This competitive continuation seeks to extend a highly successful longitudinal, diagnostic study of 401 tribally enrolled Ojibwe children (aged 10-12 years at wave 1) and 511 of their caretakers through adolescence and the high school years. The continuation would support four additional waves of data from ages 14-16 years through ages 17-19 years. This study and its companion study of 342 Ojibwe children and 469 of their caretakers (launched one year later) make up the only contemporary longitudinal diagnostic study of American Indian children at these ages.The overall goal of this continuation is to investigate the effects of early onset substance abuse reported in the first four waves on transition to regular use and associated mental health and behavioral outcomes during the critical high school years. The study will use prospective data to 1) investigate culturally specific protective factors that exist within the Ojibwe culture that may prevent, delay, or reduce the consequences of early onset substance abuse and transition to regular substance;and 2) investigate risk factors that are associated with indiviudal characteristics and the social contexts of the Ojibwe children during their high school years. Our baseline data suggest two potential pathways to transition to regular use among the Ojibwe children. The first is the risk associated with early behavioral disorders among approximately 10% of the adolescents who met diagnostic criteria for conduct disorder, oppositional defiant disorder, or attention deficit/hyperativity disorder.The second pathway is less understood and more deeply associated with social context. There is generational evidence that for a large number of American Indians, early substance abuse is not adolescent limited, but may have life-long consequences. This prospective study is ideally situated to investigate this important cultural variation in substance abuse pathways: 1) it incorporates culturally adapted key constructs of risk and protective factors;2) it provides innovative culturally specific measures of risk and protective factors that were created at the study's onset;and 3) it will provide information from early onset of substance abuse through transitions to regular use and related critical transitions as the adolescents move through their high school years. The investigators will work with the tribal governments to plan for the use of these data to develop and implement empirically-based preventions aimed at reducing early onset alcohol and drug use among Ojibwe children.